| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
5,395 |
1,880 |
$979K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
3,633 |
3,633 |
$376K |
| E1399 |
Durable medical equipment, miscellaneous |
681 |
484 |
$306K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
149 |
149 |
$304K |
| K0001 |
Standard wheelchair |
6,296 |
6,293 |
$296K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
1,033 |
1,028 |
$263K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,172 |
1,157 |
$182K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,300 |
2,298 |
$148K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,853 |
1,819 |
$128K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
503 |
392 |
$94K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
755 |
754 |
$80K |
| E0305 |
Bed side rails, half length |
2,056 |
2,055 |
$73K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
648 |
648 |
$70K |
| K0003 |
Lightweight wheelchair |
451 |
451 |
$68K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,244 |
1,237 |
$67K |
| E0245 |
Tub stool or bench |
802 |
801 |
$44K |
| K0007 |
Extra heavy duty wheelchair |
153 |
153 |
$44K |
| E0156 |
Seat attachment, walker |
2,319 |
2,317 |
$39K |
| E0272 |
Mattress, foam rubber |
296 |
296 |
$32K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,359 |
1,358 |
$29K |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
114 |
114 |
$26K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
500 |
497 |
$24K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
62 |
62 |
$18K |
| K0040 |
Adjustable angle footplate, each |
121 |
121 |
$16K |
| K0006 |
Heavy duty wheelchair |
145 |
144 |
$13K |
| E2624 |
Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
42 |
42 |
$13K |
| E2395 |
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
50 |
50 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
402 |
402 |
$7K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
76 |
76 |
$5K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
29 |
28 |
$4K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
12 |
12 |
$3K |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
24 |
24 |
$3K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
39 |
39 |
$3K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
62 |
62 |
$3K |
| E2389 |
Power wheelchair accessory, foam caster tire, any size, replacement only, each |
25 |
25 |
$3K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
25 |
25 |
$2K |
| E2210 |
Wheelchair accessory, bearings, any type, replacement only, each |
40 |
38 |
$2K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
12 |
12 |
$2K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
56 |
56 |
$766.52 |
| E0241 |
Bath tub wall rail, each |
26 |
26 |
$752.87 |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
12 |
12 |
$717.84 |
| E0244 |
Raised toilet seat |
12 |
12 |
$556.05 |